Physicians

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Tell Us About Yourself

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*Are you a U.S. citizen or permanent resident?
*Are you in medical school?
*Attending/Attended AMA- or AOA-accredited school?
*Are you in a residency program?
*Where does/did your residency take place?
 
*Do you have a U.S. medical license?
What is your specialty? (choose one)

Collection of information is authorized by Title 5 U.S.C. 301, Departmental Regulations, and E.O. 9397. For official use only when filled in.